Leicester health screening

As the Mental Health Taskforce launches, Leicestershire Partnership NHS Trust illustrates how they are leading the way in caring for the physical health of mental health inpatients.

A mental health provider is making sure mental health patients from Leicestershire and Rutland get crucial physical health checks to reduce their risk of physical diseases like diabetes and heart disease.

Leicestershire Partnership NHS Trust (LPT) is one of just a handful of trusts in the country driving through changes to ensure the physical health of people with mental health illness is treated as importantly as their mental health.

The trust, which provides mental health, community health and learning disability services for a population of around a million people, has developed a physical health register to make sure every adult on its mental health wards get a ‘physical MOT’ or set of checks including weight, blood pressure and blood tests and is asked about smoking, alcohol consumption, substance misuse and diet.

If any of the above show signs of concern they give them advice, signpost or refer them to services where they can get help for example weight management or stop smoking services.

People with serious mental health conditions including bipolar affective disorder, schizophrenia and schizoaffective disorder die up to 20 years earlier than those without; which is the life expectancy people had in the 1950s.

Dolly Sud is a specialist mental health pharmacist at the Trust and was part of a multidisciplinary team which developed the Leicestershire Physical Health Register.

She said: “It is not acceptable that people with mental health illness are not offered the same interventions and advice for their physical health as other people or patients and therefore are dying younger. We can help to improve the physical health screening and interventions with a hands-on approach.

“At LPT we are aiming to bridge that gap and make sure there is a clear equality between mental and physical health services and that the offer the patients get is the best.”

The Trust developed the work as a part of a national CQUIN, a quality improvement development project supported by the trust and they achieved 97 per cent compliance as part of this.

When a patient is admitted to any LPT mental health ward all the screening that can take place is undertaken by the junior doctor; this would usually include blood tests initially. Once the patient is well enough a healthcare professional such as a nurse or doctor will ensure the full complement of information is gathered.

The physical health register ensures the results are followed up making sure, for example, that if a patient is overweight they would receive advice about diet and exercise and if necessary referred to or get seen by a hospital dietician to talk them through lifestyle options and give advice.

“This started off as being a project and we weren’t sure exactly how it might work. But it’s quite simple and now it is business as usual for our trust – we’ve really upped the ante. What we want to do now is work out how we can follow up with the patients to see how the advice or intervention we have given tem helps them to stay well and improves their physical health in the long term,” Ms Sud added.

Dr Pete Miller, chief executive of the Trust, said: “We believe that this simple but innovative approach could have a significant positive impact on the physical health and wellbeing – and ultimately life expectancy – of people with mental ill health not just here in Leicester, Leicestershire and Rutland but potentially across the country.”

Anthony Oxley, LPT’s head of pharmacy, said: “As the emerging risk of physical health problems such as diabetes and cardiovascular disease in patients with SMI has become apparent it is vital that Mental Health Trusts take this seriously and ensure their patients are properly monitored and interventions undertaken to minimize and manage such risks.

“Whilst manual systems have a place in this, an automated system that does not rely on an individual remembering to carry out a test is the optimum system.

“This is what we in Leicestershire have been working on. A multidisciplinary team has led the project with all project leaders actively engaging with system users to ensure they understand their responsibilities.

“The successful CQUIN achievement was possible due to a combination of the computerised system and the team’s relentless focus on ensuring that all patients benefitted from it. At the end of the day this CQUIN is about patient safety and I am incredibly proud that the LPT team achieved the very high standard which they did.“